History of Chiropractic Care

The roots of chiropractic care can be traced all the way back to the beginning of recorded time. Writings from China and Greece written in 2700 B.C. and 1500 B.C. mention spinal manipulation and the maneuvering of the lower extremities to ease low back pain. Hippocrates, the Greek physician, who lived from 460 to 357 […]

Medicare Increases Scrutiny of Anesthesia Billing

Medicare is increasing its scrutiny of anesthesia billing as a result of recovery auditors finding a high percentage of errors involving the incorrect use of the HCPCS modifiers for anesthesia. These errors are specifically associated with situations when anesthesia was provided by a CRNA and anesthesiologist without a 50% reduction as per Medicare guidelines involving […]

Vintage Medicare Poster from 1968

near-65-social-security

This 1968 poster informs seniors about the Medicare program that was added to Social Security in 1965 (first benefits payable in 1966). Today, nearly 50 million Americans — 15 percent of the nation’s population — depend on Medicare for their health insurance coverage. With increasing life expectancies and more boomers turning 65 every day, the number […]

Wrongful Denial of Health Claims Harms Providers and Patients

Every time a health claim is denied, an insurance company makes more money. But it’s no “wonderful life” for healthcare providers and patients when faced with a denied claim. Claim denials create significant challenges for both parties. For providers, claims follow up is a time-consuming, costly and often unsuccessful process. For patients, a denied claim […]

CMS Publishes Educational Resources for Chiropractic Services

Late last year, CMS updated and issued a pair of educational resources that address Medicare coverage of chiropractic services. The Medicare Learning Network booklet on chiropractic services (pdf) outlines the standards chiropractors must meet to render payable services under the program; common care provision scenarios (including exceptions) and actions that Medicare would take as a […]

Medicare Increases Scrutiny of Billing E/M Services With Allergy Testing or Allergy Immunotherapy

Medicare is paying closer attention to organizations that bill evaluation and management codes reported with allergy testing or allergy immunotherapy. This is according to a recent issue of Medicare Quarterly Provider Compliance Newsletter (pdf), a newsletter from CMS developed to help providers understand the major findings identified by Medicare administrative contractors, recovery auditors and other […]

Free EHR Resource: ‘EHR Contracts: Key Contract Terms for Users to Understand’

The Office of the National Coordinator for Health Information Technology has released a free, downloadable guide designed to assist providers who plan to acquire electronic health record (EHR) systems. The guide, titled “EHR Contracts: Key Contract Terms for Users to Understand,” is intended to help buyers better understand critical EHR contract terms. As the report […]

PGM’s Credentialing Specialist Justine Marquard Contributes Credentialing Article to Becker’s ASC Review

Justine Marquard, credentialing specialist at Physicians Group Management, has contributed a column to ambulatory surgery center (ASC) publication Becker’s ASC Review. The story is titled “10 Best Practices for ASCs to Ensure Successful Credentialing.” To view the column, click here. Becker’s ASC Review features general business, legal and clinical guidance on topics including joint ventures, […]